Seven Essential Steps to EHR Development and Seamless Implementation

Sergey Avdeychik

Sergey Avdeychik

Director of Healthcare Technologies at Andersen

Oct 12, 2020
Lesedauer: 5 Min.

Patient Health Records have come a long way from the time of yellowish parchments from ancient Egypt to the digital form on the screen of a tablet. Today, Electronic Medical Records (EMRs) and Electronic Health Records (EHRs) as a broader concept is a must-have in the world of modern healthcare. But how to introduce EHRs at a clinic? In this article, we’ll try to figure this out.

EHR systems are used to record, store, and manage patients’ health information. This functionality can be augmented by integrating EHRs with other health information systems, platforms, and devices. Thus, via EHRs, authorized clinical staff get immediate access to the patients’ case-records, test results, medical histories, appointments, medications, and other relevant data.

EHR computer software also contributes to a smooth workflow in healthcare facilities. It simplifies the keeping of clinical records and reporting of information. In combination with other solutions like RTLS and TeleMedicine apps, it helps medical personnel to track the availability of wards and beds, perform clinical processes like admissions and discharges, follow up with patients, monitor their vital signs between visits, and much more.

In addition, patients always have access to their essential health data through EHR-connected patient portals. This allows patients to be better informed about the state of their health as they can easily view their lab results, medical images, prescriptions, insurance plans, and so on. Patients are able to have better medication adherence and receive medical provider’s instructions faster.

The advantages of EHRs

The US Office of the National Coordinator for Health Information Technology (ONC) names the following advantages of EHRs over the hard-copy document workflow:

  • Data availability.

Patients’ medical information is complete, accurate, and accessible 24/7, which facilitates more coordinated and efficient care.

  • Improved and secure interaction and communication between a patient and a provider.

Only authorized users have the right to view, use, and share patients’ information. Patients have better access to care while providers can easily create referrals and e-prescriptions, as well as exchange images and lab results.

  • Improved providers’ productivity thanks to streamlined clinical workflows.

EHRs allow for better scheduling for patients and personnel, streamline medical coding and billing, improve providers’ work-life balance, and reduce costs for care.

  • Increased safety for patients

Accurate personal identification allows for more precise medication prescribing, reduction of medical errors, and improved clinical decision-making with the help of a clinical decision support system embedded in EHR.

EHRs prove themselves to be effective not only in the routine practices of general hospitals and dental clinics. They have turned out to be extremely useful during the Covid-19 outbreak when temporary healthcare facilities needed to be equipped in a matter of days. Perhaps one of the recent examples of EHR effectiveness is the high rate of Covid-19 vaccinations in Israel, which was achieved in a very short time thanks to the effective health information system covering 100% of providers and 100% of the country’s residents. This allowed Israeli health authorities to effectively establish the prioritization of vaccination and implement it quickly.

How to develop and implement EHRs at a clinic

The following steps should be taken into consideration when developing and implementing an EHR system.

  1. Deciding on the primary approach.

Responsible healthcare executives can choose between acquiring (and tailoring) an off-the-shelf solution and building their own. In the former case, the implementation of the EHR system might be faster and upfront costs could be lower. Not all the features can be customized though, and the cost of such tailoring can be quite high. And conversely, most practices don’t need all the features included in the off-the-shelf product.

Another major concern is suboptimal usability and user experience of some off-the-shelf solutions, contributing to a provider’s burnout. EHRs interoperability is still an issue, too.

Taking into account these obstacles, the development of custom EHR software from scratch can be a reasonable option. Among the advantages of this approach are:

  • complete and customized set of features,
  • advanced UI and UX design leading to shorter EHR adoption time and greater end-user satisfaction,
  • an array of integrations tailored to the practice’s needs,
  • improved security from the onset and lower support costs.

The main disadvantage of EHR software development from scratch is its higher cost and longer implementation time.

  1. Determining the EHR implementation project scope.

Implementing unnecessary features makes a project more complex and costly. That’s why it is essential to clearly identify the business needs of a practice and the clinical processes to be automated. The location of a facility and patient load are also important.

The cost of EHRs varies depending on the complexity of their features and integrations, project timeframes, and other factors. If you opt for a custom EHR, the vendor’s Presale Team will evaluate your requirements and provide a detailed plan of the steps for EHR development.

  1. A Discovery Phase.

During this 4- to 8-week stage, a healthcare software development company gathers necessary information about the business needs of a customer, end-user profiles, system requirements, and so on in order to picture the future custom EHR system precisely. In complex software products like EHRs, the Discovery Phase saves resources needed for development.

Having finished this stage, a software development company delivers the vision of the future EHRs and a scope document, architecture diagrams, initial backlog, software requirement specification (SRS), a test plan, and design documentation (design concept, wireframes, and prototypes). In the course of the Discovery Phase, cooperation with the customer is very important as it is essential to capture the workflow in a healthcare institution and receive exhaustive feedback from major stakeholders.

  1. Custom healthcare software development.

When the Discovery Phase is over and the vision of the future custom EHR software is well-elaborated, the development stage starts. The average timeline for EHR software development is 6-18 months. The development is usually performed by an experienced team of healthcare software developers according to the Agile methodology and involves close cooperation with representatives of the customer who is the Product Owner.

Needless to say, custom EHR software programs must be compliant with patient data security requirements (GDPR, HIPAA, HITECH, and others) and, in most cases, should be certified accordingly (for example, ONC Health IT Certification is essential for the USA market).

Contemporary EHR software must be integrated with various health information systems like patient portals, practice management systems, PACS for medical imaging, laboratory information systems, and clinical decision support systems. Also, it is crucial to integrate your EHRs with remote patient monitoring devices, drug databases, e-prescription services, clearinghouses, insurance companies, and payment systems.

  1. System implementation.

The introduction of an EHR system into a clinic’s workflow involves several stages. The facility managers need to form an implementation group that will assist the staff when adapting to the new platform. This team should include tech-savvy personnel that will communicate the progress and issues arising to the developers. Another stage is to appoint or hire specialists who will carry out the transfer of documentation from hard copy to electronic format.

As studies show, the proper training on the newly introduced EHR system is the greatest predictor of clinical staff satisfaction with the new solution. Usually, the introduction of a new EHR platform into a clinic’s workflow takes 3-6 weeks. An ongoing training plan is also indispensable as new employees must be properly trained for using EHRs. It is also good practice to encourage proficient users from among nurses and doctors to share their experience during staff meetings and refresher training sessions.

  1. Feedback and support.

Professional healthcare software development services guarantee ongoing technical support after the EHR system has been launched. It is also important to enable health workers to give their feedback on the system so that it can be improved and tailored to the requirements of each team.


EHR software is an advanced technology for improving medical care on the one hand and a challenge on the other hand. Data safety, interoperability, and product usability are still issues to be carefully considered in the course of development. Nevertheless, correctly built and implemented EHR software is a great helper in streamlining a healthcare facility’s processes and increasing its efficiency and quality of care.

Andersen specializes in developing custom healthcare software solutions. Contact us for a healthcare IT consultation to discuss the best opportunities for your business.

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Sergey Avdeychik, Director of Healthcare Technologies at Andersen
Sergey Avdeychik

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